The Birth of Julian: My Triumphant VBAC
I started my second pregnancy with a lot of fear and anxiety. I so badly wanted to make this birth experience different than my last one, which had been a c-section that left me devastated and hurting on my levels. I needed a lot of reassurance from my midwives throughout my pregnancy, as it progressed I slowly started to regain faith that my body could do this, and that it would be different than last time, although at times my doubts and fears would come back to plague me up until the end. I made plans for several different outcomes while still trying to affirm the positive. The last few weeks of pregnancy were very hard on me mentally and emotionally. I was sick and tired of being big, and pregnant and waiting to go into labor. I had five days of contractions that came on and off before the real thing started. These bouts of contractions had me hopeful every time that labor was going to start only to disappoint in the morning when they stopped. I struggled between wanting to wait and let my baby choose his/her birthday, and wanting to do something to encourage labor to start, as I was afraid of getting tired out with these start/stop contractions before labor even began. Also, my midwife was really firm about not being comfortable with the pregnancy going past 42 weeks, and I was already past 41. My midwife also was starting a new job (retiring from her midwifery practice after 20 yrs) if I didn’t have the baby that weekend she wouldn’t be able to attend my birth. I was counting on her to be there, and for my emotional and mental well-being I really needed her there, but was feeling super stressed about the situation: the chance that she wouldn’t be there, and the chance that I would go to 42 weeks or beyond and lose my chance to VBAC. My husband also got food poisoning that took him three days to recover from while I was on the verge of going into labor.
On Friday the 17th of December, when I was 41+2 I agreed to a cervical check and gentle stretch and sweep to encourage labor. I felt like I had been on the verge of going into labor for days. My in laws arrived in town and rented a hotel and took my 3-year-old son for the night, as we had agreed they were responsible for watching him while I labored and birthed. My sister, who is chiropractor, came by and adjusted me in hopes that my help my body go into labor. Contractions started again in the late afternoon, and I knew I should try and rest but I took a warm bath with candles and talked to my mom instead, and had a good cry. My midwives had also started me on a regimen of black and blue cohosh of which I had taken two doses that afternoon. It tasted seriously nasty. But I had refused to drink castor oil, which was the other alternative they suggested. I did another round of black and blue while watching a funny show on TV that night, and noticed contractions throughout. We went to bed and I got some rest, although not much, as I kept contracting. I had talked and cried to my midwife earlier that night on the phone, and she knew I might call her back if contractions got any stronger. Well, I ended up getting up, and wandering the house, sitting on the toilet, and being upright. Around 2:00 A.M I realized I needed to vocalize through contractions and having some difficulty dealing with them. I remember debating about calling the midwives (I really didn’t want to call them to early) and I kept thinking maybe I could hold out until a more reasonable hour 5:00 or 6:00 A.M. Then after another contraction I decided I wanted them there (and of course midwives are used to being called at all hours!) I called and she was on her way, I knew it would take her about an hour to reach our house. Contractions started getting harder, and I asked my husband to fill the birth pool. I remember loving the relief of the warm water so much in my last labor, but when I got in during a contraction this time, it felt just as painful and didn’t relive much of anything and I felt frustrated. Once we added warmer water to increase the temperature it was better. Then my midwives were there. The morning passed with me laboring in different positions and places. I labored on the toilet, in the tub and kneeling on the floor and laying my torso over the side of the bed. I was groaning through every contraction. Midwives were in our living room, giving my husband and I space. They would come in regularly to listen to heart tones. I know that one midwife charted and did heart tones while the other slept or ate as the morning wore on. I didn’t really have much concept of time passing, but once I looked at the clock and saw that it was already 10:00 A.M and my hope for a short labor vanished. I had thought, previous to labor, that I might call my sister, and ask her to be present and to take pictures, but those thoughts had long since left me. I wanted to stay in the tub and labor, because it hurt less, and because it fit my vision of a peaceful, candlelit labor. And I had some lovely moments in the tub. The warm water was relaxing, the lights were low, and my labor/ birth CD was playing in the background. It was very private. But the fact was that it was not helping my labor progress. My contractions were pretty far apart (8 to 10 minutes) and my midwives suggested getting out of the tub. I tried sitting on the toilet for a while but felt a good deal of pressure there. I restlessly wandered the house for a bit, worked through a few contractions while standing in the kitchen, drank sips of juice offered and ate some pieces of honeydew melon, and some cliff bar. My midwife suggested lying on the bed in a position that I had used a lot during pregnancy (when we were working on preventing a posterior baby) and I reluctantly agreed. I knew contractions would be hard to deal with lying down, but she promised me that she would stay by my side and help me through every one. We also did a move they called the “doula hula” where I was on my knees with my chest on the bed, and butt sticking up in the air, and moving my hips in figure eights. I remember thinking that felt really sexy and I almost said that aloud, but felt like it would sound to weird, I was also getting really tired and wishing I could sleep at this point. I worked on relaxing between contractions, and I could almost drift off and fall asleep, until the pain of another contraction coming on would hit me. When I could start my breathing at the beginning of the contraction as it built I could deal much better. My midwife told me how to breathe better with them, to try and let go and relax as I was tensing up my whole body. It was so hard to relax into the pain, if felt more natural to try to get away from it. I know I started tensing up and fearing the next contractions and I started screaming and crying through them. Those hours laboring on the bed were probably the worst parts of my labor. I could feel the intense pressure of the baby working it’s way down through my bones, which I never felt during my first labor. (My son remained high and never descended, hence the c-section). I don’t remember all the comments I made between contractions but I know I complained a lot. I’ve always tended to be a complainer in life. I remember thinking that all my thinking, ideals and education about natural childbirth was insane, that trying to do this at home was insane, that my midwives and every other woman who has had a baby at home was insane. I became convinced that all the natural childbirth videos that I had watched, where it all looked so peaceful and beautiful were lies. The pain felt like it was endless. I saw no end in sight, it felt like I was going to be in pain forever and the baby would never come out. The pain felt bigger than me, like I was just lost in a sea of pain, and the baby was never coming, the agony would never be over. I started to dream of getting drugs, they would take the pain away. I even started to contemplate another cesarean, thinking in the midst of my pain, that it wouldn’t be so bad to be cut open; at least the pain would stop. But I also remembered all the pain of physical recovery after a c/s and all of the trauma and emotional pain, and I knew I didn’t really want that. Plus, I would never forgive myself for wimping out on my vbac. I had been working on this for three years. Ever since I was headed to the OR during my first labor. My midwives and I started discussing pain relief, but the problem was being a vbac there really weren’t options to transfer to a hospital to get an epidural and still proceed with a vaginal birth. Somewhere in the back of my mind I knew I didn’t want to transfer anyway. I wanted the pain to stop, but I didn’t want everything else that came with a transfer to hospital, especially as a vbac, since that would in all likelihood be a repeat c-section. So I decided I could keep going, I could try to surrender to the pain, and let it hurt even more. It was during this time, that my husband piped up with the comment: “ At least he baby will be here before Monday” I wanted to kill him, and I screamed “SHUT THE FUCK UP” Later he told me that he was trying to be encouraging because it had been a big concern of ours that the baby wouldn’t be born this weekend when our midwife could be there. But really, he must have been clueless as to what I was feeling at the time. He’s forgiven now, though.
With one of my next strong contractions my bag of waters broke all over the bed. I was so happy; I broke my own bag of waters! This was a big milepost, as I always believed that when AROM was performed in my first labor that it led to problems and had been determined to avoid it this time. Water was clear and all was still good. I don’t remember how much time passed at this point, but in my memory it seems like not long after my water broke the midwives were listening to heart tones and suddenly got very serious and I knew things were not good. I rolled onto my side and they listened again, and then told us we would be transferring to the hospital immediately. I got scared and I can’t remember if I just thought this or said aloud that I was afraid of losing my baby. I had had many fears about a failed vbac during my pregnancy, but the worst fear was that I would have a stillbirth. I remember the fear that struck in my heart when the midwives said baby was in trouble and we were going to the hospital. They were urgent and extremely serious in their demeanor. I think I started to cry and my midwife said she was sorry, but she was all action. My husband went to the closet and began to grab clothes to pack a bag, as I had nothing packed, thinking it would be at home this time. Somebody found clothes for me, and helped me into them. The midwives urged my husband to hurry, he was taking to long. One of them called the hospital while the other got her car ready. I could hardly walk out the door I was in so much pain every time a contraction hit. I remember walking out onto the porch and down the stairs and as a contraction hit I was screaming, and someone was riding by on their bicycle. I laid down in the back of the midwives car on a mat and one midwife drove while my husband rode next to her in the front, and the other midwife rode in the back with me and kept the Doppler on, listening to heart tones during the drive over, and helping me through contractions. I remember being in so much pain and screaming through contractions, and being told to breathe for the baby. I also was in emotional anguish as this point as I knew that I was going to have a repeat c-section, and I was scared for my baby’s well being. So while I was heartbroken to be facing surgery again and I knew I was going to feel devastated and broken, I wanted more than anything for my baby to be okay.
We arrived at the hospital right around the corner, but had some trouble finding the right entrance, and when my midwife parked in front of it she said “third times the charm” meaning we had finally found the correct entrance, but I remember thinking “If she thinks I am going to try this a third time, she’s insane!” I was dreading our reception by hospital staff as last time it was so horrible, and here we were transferring from another homebirth attempt to a vbac ban hospital in a town that does not encourage homebirths. My midwife went and got a wheelchair and then I was being wheeled to labor and delivery, screaming with contractions the whole way.
Once we got into a labor room all the admittance procedures began, I got into a gown, they hooked me up to a monitor and then were working on getting a monitor on the baby’s head, but needed to get a new wire, I remember wishing they would just hurry. Contractions on the bed were not easy to deal with. I was hooked up to an IV, and asked for pain relief. An epidural takes time, so they gave me half a dose of a narcotic for the time being. The on call O.B came in, and I remember only parts of the conversation going on around me. I was having trouble verbalizing much, but did talk to my midwives between contractions. The labor nurse and the O.B both checked me, looked at the monitors, talked to my midwives about the specifics of the labor, when it had started, what time my water broke, etc. My midwives gave the OB my cesarean birth plan, and I expressed to him that I would have a cesarean if it was truly medically necessary and the best course of action for the baby, but that I wanted to be included in the decision this time, and feel like a participant in the process. He was very kind and encouraging about it, and seemed willing to work with us. I know there was then talk about the fact that I already had a previous cesarean and I remember thinking that was surely a strike against me. I don’t really remember exactly what happened next, but I know the doctor and nurse were in and out of the room, and then my midwife was telling me I still had a shot at a vbac if I could start pushing for real and show the doctor that I could move the baby down. I was already involuntarily bearing down with my contractions. I signed their VBAC form, and also a cesarean consent form just in case. Everyone was watching the monitors closely. My labor nurse was very sweet, and encouraging and super supportive. She was really great, and wanted me to succeed. The doctor was totally respectful to my midwives and very decent to us. I never felt bad or judged for being a home birth transfer, so very different from my older son’s birth. At first I didn’t really know how to push, but I started to get the hang of it. I pushed on my side, holding my leg back. At one point, the labor nurse told my midwife “ I don’t know exactly what you do to help women birth, but do it, and I’ll shut the door, and knock when I need to come back in so you know it's’ me." Then it was just my midwives and husband and I for awhile and my midwife started helping me push, and encouraging me and for a few contractions I got up on my knees on the bed (one leg bent and on one knee) and tried pushing that way, but was actually making more progress on my side. I got excited and thought; maybe my midwife will actually catch this baby! But I couldn’t push that fast. The baby’s heart tones were still being watched closely, and I heard c-section mentioned a couple more times during pushing. At that point my midwives and husband told me they could see the head during my pushes and I thought “Hell no, there is no way I am being cut open again when you can see the head!” I really got down to business putting everything I had into pushing. Pushing still hurt, but I liked it a lot better than those earlier contractions when the baby had been spreading my bones. There was a point during the push that felt satisfying, and actually good. I could feel myself making progress and that really motivated me. I wish that I had been able to see my progress in a mirror but they didn’t have one. The doctor came back and was sitting at the end of the bed, but I really wasn’t too aware of him. I was now pushing on my back, but curling my upper body with each push. I started to feel burning and stretching, and I welcomed the sensations and got excited as I realized it really meant my baby was coming. The ring of fire wasn’t nearly as bad as I had heard. My midwife asked me if I was pushing in between contractions as well, and I think that I was, I was just so focused on getting the baby out, and I could scarcely believe this baby was really going to come out through my vagina! During one of my pushes, my midwife encourage me to reach down and touch the baby’s head, and that was amazing and the moment I truly realized that my baby was going to come out of my vagina! I was really giving birth! Then the head was out, and the rest of the body, and it such a relief. Baby was brought right up and put on my chest, and that rush was unlike anything I have ever experienced. My midwife reminded the doctor that we didn’t know the sex, and wanted to find out for ourselves. The doctor said something like “ Oh, that’s the best part of my job” but I think in good humor. Anyway, I looked over at Micah and saw that he was crying. I think that memory will always stay with me. We then discovered together that we had another boy. My husband was really surprised and he had been convinced it was a girl, but I wasn’t. My midwives were snapping pictures and then I realized I still had the placenta to deliver. I think the O.B did some gentle cord traction and delivered the placenta. That was easy in comparison to a baby. It was a big relief when the placenta was out. The only thing that was not followed on our birth plan was that they would not allow us to take our placenta home, and I actually never got to see it, and would have like too. Oh, well it’s really not a big deal to me compared to everything else. I avoided the knife and so everything else feels like hardly an issue. I had sustained a labial tear that was bleeding and the doctor decided to suture it. That wasn’t bad as I got to hold my baby in my arms while he sewed it up. I was elated.
Julian Liam Darden was born weighing 6 lbs 150z, 19 and ½ inches long, on December 18th at 6:37 pm via a triumphant, victorious VBAC at a hospital with a VBAC ban in place. Giving birth was one of the best, proudest moments of my life.
I didn’t know this at the time, but my midwife told me at one of my postpartum appointments that during the moments of transfer she thought I could be having a uterine rupture. Apparently heart rate decelerations (baby’s heart rate was in the 70;s and 80’s) in combination with the fact that my cervix was reversing in dilation ( I had been at an eight and was closing down) can be a sign of impending rupture. No wonder she thought I would be having a repeat c section as soon as we got the hospital. I knew heart tones were bad, and baby was in trouble but not the rupture part during transfer. I’m glad I wasn’t aware of that at the time, and so grateful that it didn’t turn out to be the case, although I feel if it had been , while I would have had a lot of difficult feelings to deal with and probably felt like a failure, I would have been more at peace with a section under those circumstances than the first time. And I believe if I had had to have a cesarean, the O. B on call that day would have tried hard to make it an experience I could feel good about. I am so glad I was led to this midwife and that I chose her to attend my birth. She was absolutely the person I needed with me during this birth and her prompt action kept me and my baby safe. She will always have a special place in my heart. Corny sounding I know, but true.